Burns : journal of the International Society for Burn Injuries
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Burns are noteworthy causes of morbidity and mortality in India. Community-based interventions in the forms of multi-strategic and multi-focussed preventive programs are, however, lacking. This study, undertaken in the remote corner of Northeastern India, aims at reducing the incidence of burns through focussed attention towards sensitising the community with well-structured preventive programmes. ⋯ Increased awareness amongst the general population was reflected by reduction of average reporting time in hospital after injury and significant reduction of firecracker burns from 21.5% (block I) to 14.6% (block II). Similarly, improved awareness amongst the students was evident from the improved scoring by the majority of the students and reduction in burns amongst them in the later part of block II. The results indicate that BPP has made a positive impact in society.
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Despite advancements in the provision of burn care, there is still a significant cohort of patients who fail to respond to therapy or for whom treatment is deemed futile. The decision to withdraw support from, or to implement a Do-Not-Resuscitate (DNAR) order in, such patients can be challenging. Our aims were to review the withdrawal of life-sustaining treatment, issuing of DNAR orders and end of life care in burn patient deaths. ⋯ A coherent, decisive approach should be adopted and adhered to by all members of the multi-disciplinary team, with clear, standardised documentation in place.
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Self-inflicted burns (SIB) are responsible for 2-6% of admissions to Burn Units in Europe and North America, and for as many as 25% of admissions in developing nations. Recently, a promising new tool was proposed to stratify SIB patients in the following subgroups: "typical", "delirious", and "reactive". However, as far as the authors know, the clinical usefulness of this instrument has not yet been validated by others. ⋯ There was a slight predominance of the "typical" type (44.6%), followed by the "delirious" type (30.4%), and, finally the "reactive" type (25.0%). Mortality was significantly higher in the "typical" subgroup. In conclusion, the SIB-Typology Tool appears to be a valuable instrument in the clinical management of SIB patients.
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Preserving function of the hand is the aim of treatment in burned hands; appropriate splinting is one of the important measures during acute and chronic treatment. We introduce an effective safe method for positioning of fingers without violating the joints; In this method before performing skin graft for palmar finger burn or contracture release we suture tip of finger with silk 2-0 and fix it to dorsum of hand while extending the finger and for preventing slipping we insert some pulley like circles tied with silk 2-0 fixing over dorsum of mid phalanx.
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First web space adduction contractures are a common consequence of hand burns. Many reconstructive techniques are used and investigation for more effective methods continues. Effective hand reconstruction usually considers anatomy as its foundation. ⋯ Total contractures (about 10% of all) have no fold. Reconstruction consists of the creation of the central zone of the first web space depth with the rectangular subdermal pedicle flap; the wounds on both sides of the flap are skin grafted. The flap sustains normal web depth and prevents the contracture recurrence and skin graft shrinkage.